Participants at an Agency for Healthcare Research and Quality National Advisory Council forum expressed concern that physicians could begin “firing” their non-compliant patients to meet quality goals, according to an article in CQ Healthbeat.

The article states that as physician payments become closely tied to quality measures, patients who do not follow doctor’s advice for things such as receiving vaccines, may be at risk of losing their physician so that the physician, in turn, does not lose payment.

To account for this possibility, council members proposed altering the measures to account for physicians recommending the advice, or to set the goal at some point under 100%.